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Pelvic congestion syndrome, also known as pelvic vein incompetence, is a long-term condition believed to be due to enlarged veins in the lower abdomen. [ 1 ] [ 7 ] The condition may cause chronic pain , such as a constant dull ache, which can be worsened by standing or sex. [ 1 ]
Varicosities, [7] e.g. enlargement of the blood vessels of the round ligament can occur during pregnancy, causing pain and swelling. The varicocoele starts at the veins draining the round ligament and the inguinal canal and is associated with engorgement of the veins of the ovaries and the pelvis during pregnancy.
Treatment involves elevation of the legs and pressure stockings to relieve swelling along with warm sitz baths to decrease pain. [41] There is a small amount of evidence that rutosides (a herbal remedy) may relieve symptoms of varicose veins in late pregnancy but it is not yet known if rutosides are safe to take in pregnancy. [25]
Many patients with lower limb varices of pelvic origin respond to local treatment i.e. ultrasound guided sclerotherapy. In those cases, ovarian vein coil embolisation should be considered second line treatment to be used if veins recur in a short time period i.e. 1–3 years. This approach allows further pregnancies to proceed if desired.
The distal veins are removed following the complete ablation of the proximal vein. This treatment is most commonly used for varicose veins off of the great saphenous vein, small saphenous vein, and pudendal veins. [60] Follow-up treatment to smaller branch varicose veins is often needed in the weeks or months after the initial procedure.
Studies show that all of these issues can arise from lying in the supine position during late pregnancy, which can cause compression and obstruction of the inferior vena cava by the uterus. [1] Symptoms of late pregnancy inferior vena cava syndrome consist of intense pain in the right hand side, muscle twitching, hypotension, and fluid ...
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